Active NPI
Jalyssa Jackson
- Social Worker
- Dayton, OH
National Provider Identifier
1679294987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 6313 Springboro Pike Apt 37
Dayton, OH 45449-3421 - Phone
- (937) 409-8489
- NPI assigned
- Sep 6, 2022
- Last updated
- Sep 6, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
6313 Springboro Pike Apt 37
Dayton, OH 45449-3421
Mailing address
199 S Central Ave
Columbus, OH 43223-1301
Phone (614) 273-2273
Other practice location 1
199 S Central Ave
Columbus, OH 43223-1301
Phone (614) 273-2273
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662422400000",
"number": "1679294987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "199 S CENTRAL AVE",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432231301",
"telephone_number": "614-273-2273"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6313 SPRINGBORO PIKE APT 37",
"city": "DAYTON",
"state": "OH",
"postal_code": "454493421",
"telephone_number": "937-409-8489"
}
],
"practiceLocations": [
{
"address_1": "199 S Central Ave",
"address_purpose": "LOCATION",
"city": "Columbus",
"state": "OH",
"postal_code": "432231301",
"country_code": "US",
"telephone_number": "614-273-2273",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACKSON",
"first_name": "JALYSSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-06",
"last_updated": "2022-09-06",
"certification_date": "2022-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.